The heart and brain in danger too

The ongoing Covid-19 pandemic has wreaked havoc on people. According to a recent study in Sweden, it increases patients' risks for heart attack and stroke. The study compared 86,742 individuals infected with SARS-CoV-2 in 2020 and 348,481 people without the virus. In the week following a COVID-19 diagnosis, the risk of a first heart attack went up three- to eight-fold, and the risk of a first stroke due to a blood vessel blockage rose three- to six-fold, the researchers found.
The risks then dropped steadily but remained elevated for at least four weeks, according to a report in The Lancet.
The researchers did not include COVID-19 patients who had had heart attacks or strokes in the past, but for this group, the risk of another heart attack or stroke is probably even higher, said co-author Dr. Anne-Marie Fors Connolly of Umea University.

According to Dr Prateek Bhatnagar, Director Cardiac Surgery, Care Hospitals, “The basic pathology of inflammation in Covid-19 leads to a hypercoagulable state and also increases pre-existing blocks in coronary arteries.”
The doctor, who, in July 2020 performed India's first coronary bypass surgery on a patient who had recovered from Covid-19 pneumonia but later suffered increasing angina, said, “I have operated on multiple such patients in the last one year. The good thing is that all such patients recovered well.” He adds, “We wait for a minimum of two weeks and ideally 1 month after the patient gets a negative RTPCR report and assess the lung involvement and damage,” he says. Most Covid-19 patients who have a negative RTPCR report can undergo bypass surgery at a routine risk according to him, if they have adequate pumping of the heart while patients with critical blocks and pumping loss will have a higher risk.”
Dr. Bhatnagar however notes that patients who develop Covid-19 immediately after a surgery may have suboptimal prognosis.
 “Sadly there are no precautions that people can take to avoid developing these symptoms. They have to take vaccines and make sure they maintain Covid-19 appropriate behaviour, particularly those who are known to have blocks in their coronary arteries,” is his advice.

Dr Shyam K Jaiswal, consultant neurologist, Care Hospitals, endorses the study’s findings. “Covid-19 causes the blood to thicken, leading to problems of the brain, heart, and kidney. We put Covid-19 patients on blood thinners to avoid blood clots leading to brain stroke.,” he explains.
Over 80% of the brain stroke cases develop within 72 hours of the Covid-19 diagnosis, shares Dr BSV Raju, Neuro Spine Surgeon, Aster Prime, Hospital. “The prognosis is poor; most are associated with co-morbidities like diabetes and hypertension. Early awareness of a stroke possibility is key - once an imminent stroke is suspected, immediate CT brain/MRI brain needs to be done. If detected within 4.5 hours, we can reverse the effect of strokes,” he notes.

What the study means

Dr C Raghu, Head Cardiology, Aster Prime Hospital, says, “This is the largest study till date performed in a systematic way. The authors concluded that Covid-19 is not a simple viral infection but in fact affects the heart and brain also. It is clear from this study that Covid-19 infection is an independent risk factor for developing heart attack and brain stroke, irrespective of diabetes, hypertension, smoking etc. At the end of 4 weeks of the infection, the risk of suffering a heart attack or stroke is still 60% higher. Most of the time, the latent disease is unmasked with the onset of Covid-19. The best way to prevent the cardiac consequences of Covid-19 is to get vaccinated. In addition, control of cardiac risk factors such as hypertension, elevated lipid levels and diabetes is of paramount importance.”

What are the cardiac risks a Covid-19 patient is prone to?

1. Heart attack

2. Brain stroke

3. Atrial fibrillation

4. Heart failure

5. Onset or worsening of high BP

6. Onset or worsening of diabetes

7. Thyroid problems - Hypothyroidism